Endotracheal tube construction and method for intubating a patient

Abstract

An endotracheal tube construction includes an elongated kink resistant flexible tubular member having distal and proximal ends with a curved portion therebetween. The tubular member defines a major passageway or airway and a relatively small cuff inflating lumen which is parallel to the major passageway and disposed in the wall of the tubular member. The cuff inflating lumen is positioned within a portion of the wall which is subjected to tension as the tubular member is bent as opposed to being positioned in that portion of the wall which is under compression. In addition, the portion of the wall adjacent to the lumen is thicker than the wall in other portions of the tube so that the tube is less likely to kink or collapse during intubation of a patient. The endotracheal tube includes a beveled tip and is constructed and arranged so that the beveled tip can be rotated by twisting a portion of the tube which extends out of a patient's mouth or nose without kinking or collapsing the tube. In this way, the far end of the suction catheter can be biased in the direction of the selected bronchi.

What is claimed is: 
     
       1. A kink resistant endotracheal tube comprising a flexible elongated tubular member having distal and proximal open ends, a curved portion and a wall thickness of about 0.040 inches defining a central major passageway and a secondary minor lumen extending along and through said parallel to said passageway; said tubular member including a thickened wall portion, adjacent said secondary minor lumen, forming a generally D-shaped internal cross-section and a circular external cross-section in said tubular member with said secondary minor lumen extending through the wall of said tubular member at a position between the flat side of the D and the external circular portion, so that the wall thickness of the tubular member is thicker in the area of the secondary minor lumen, and a second portion of said tubular member opposite from said thickened wall portion having structural integrity;   means including said curved portion in said tubular member for positioning said tubular member within a patient's trachea, so that a portion thereof defines an inner pathway wherein said tubular member is under compression and an outer pathway wherein said tubular member is under tension, and wherein said thickened wall portion and said secondary minor lumen is within that portion of said wall which is under tension, so that the tubular member will not kink or collapse during intubation of a patient;   an inflatable cuff or balloon of a gas impervious material secured to the exterior surface of said tubular member at the distal end thereof and communicating with said secondary minor lumen for inflation by a flow of a gaseous medium through said lumen; and   means for inflating said cuff or balloon for positioning the endotracheal tube within a patient's trachea.   
     
     
       2. A kink resistant endotracheal tube according to claim 1 in which said tubular member is formed of non-toxic material that is heat stable in its physical characteristics within the range of human body temperature to be encountered in use, has a hardness of about 80 durometer, and an inside diameter-to-wall thickness ratio of about 8:1 so that the member is non-collapsible during insertion and while in place in the trachea and is capable of withstanding a 90° bend without collapsing. 
     
     
       3. A kink resistant endotracheal tube according to claim 2 wherein the thicker wall section is positioned along the wall thickness between the minor lumen and the internal surface of the tubular member is greater than the wail thickness between the lumen and the exterior surface. 
     
     
       4. A kink resistant endotracheal tube for use with a suction catheter comprising a flexible elongated tubular member having distal and proximal open ends and a curved portion therebetween, said curved portion defining an inner pathway wherein said tubular member is under compression and an outer pathway wherein said tubular member is under tension, a wall of a thickness of about 0.040 inches defining passageway between said distal and proximal open ends and a beveled tip defining an open face at said distal end; said tubular member including a cuff inflation lumen extending along and through said wall parallel to said passageway and within that portion of said wall which is under tension;   an inflatable cuff or balloon of a gas impervious material secured to the exterior surface of said tubular member at the distal end thereof communicating with said cuff inflation lumen for inflation by a flow of gaseous medium through said lumen; and   means including the curved portion, the wall thickness and stiffness of said tubular member for positioning said tubular member within a patient's trachea so that a portion thereof is curved with said open face of said beveled tip facing one of the patient's bronchial openings and for rotating said open face of said beveled tip to face the other of said patient's bronchial openings without forming a kink or obstruction in said passageway by twisting the proximal end of said tubular member so that one end of a suction catheter may be biased into a selected one of the patient's bronchial openings for removal of residual secretions therefrom.   
     
     
       5. A kink resistant endotracheal tube for use with a suction catheter according to claim 4 wherein said inflatable cuff is adjacent to said beveled tip. 
     
     
       6. A kink resistant endotracheal tube for use with a suction catheter according to claim 4 wherein said tubular member defines a solid wail which is free of any opening between said inflatable cuff and said beveled tip. 
     
     
       7. A kink resistant endotracheal tube for use with a suction catheter according to claim 4 wherein said beveled tip defines a solid wail which is free of any openings other than its open face. 
     
     
       8. A kink resistant endotracheal robe for use with a suction catheter according to claim 7 wherein said curved portion defines an inner pathway wherein said tubular member is under compression and an outer pathway wherein said tubular member is under tension and said cuff inflation lumen is within that portion of said wall which is under tension when said beveled tip is in a first position. 
     
     
       9. A kink resistant endotracheal tube for use with a suction catheter according to claim 4 which includes a thickened wall portion adjacent to said cuff inflation lumen. 
     
     
       10. A kink resistant endotracheal tube for use with a suction catheter according to claim 9 in which said tubular member is formed of non-toxic material that is heat stable in its physical characteristics within the range of human body temperature to be encountered in use, has a hardness of about 80 durometer and an inside diameter-to-wall thickness ratio of about 8:1 so that the member is non-collapsible during insertion while in place and during rotation of said beveled tip by twisting said proximal end. 
     
     
       11. A method for intubating a patient for removing secretions from the bronchial tubes of the patient comprising the steps of: (a) intubating a patient with an endotracheal tube having distal and proximal ends with an air passageway therebetween to thereby provide a curved section with a portion thereof under tension and a cuff inflation lumen parallel with the passageway and disposed in a wall of the tubular member which is under tension, an inflation cuff secured to an outer surface of the tubular member and communicating with the cuff inflation lumen for inflation by a flow of gas and including a beveled tip adjacent to the inflatable cuff so that the endotracheal tube passes through the vocal cords without damaging the cords and into the trachea of the patient so that the endotracheal tube follows the anatomical curve between the patient's oral or nasal passage and trachea;   (b) rotating said open faced beveled tip to face one of the patient's bronchial openings without forming a kink or obstruction in the passageway by twisting a portion of the tube that extends out of the mouth or nose of the patient;   (c) inserting a suction catheter through the air passageway and biasing the suction catheter into the patient's bronchial opening; and   (d) removing any secretions from in or around the patient's bronchial opening.   
     
     
       12. A method for intubating a patient and for removing sections from the patient's bronchial tubes or the like according to claim 11 which includes the additional step of: rotating the open faced beveled tip to face the patient's other bronchial opening by twisting a portion of the tube that extends out of the mouth or nose of the patient to thereby bias the suction catheter into the other of the bronchial openings and removing any secretions from in or around the patient's other bronchial tube.   
     
     
       13. The combination of a kink resistant endotracheal tube and a suction catheter for removing secretions from in or around a patient's bronchial tubes, the combination comprising: a flexible elongated tubular member having distal and proximal open ends and a curved portion between said ends, said cutting portion defining an inner pathway wherein said tubular member is under compression and an outer pathway wherein said tubular member is under tension, a wall of a thickness of about 0.040 inches defining a passageway between said distal and proximal open ends and a beveled tip defining an open face at said distal end;   a suction catheter extending through said central passageway with one end thereof extending out of said distal end and biased in a first direction by said beveled tip and with its opposite end extending out of said proximal end of said tubular member and adapted for connection to a vacuum source;   said tubular member including a cuff inflation lumen extending along and through said wall parallel to said passageway and within that portion of said wall which is under tension;   an inflatable cuff of a gas impervious material secured to the exterior surface of said tubular member at the distal end thereof communicating with said cuff inflation lumen for inflation by a flow of gaseous medium through said lumen; and   means including the curved portion, the wall thickness and stiffness of said tubular member for positioning said tubular member within a patient's tracheal so that a portion thereof is curved with said open face of said beveled tip facing one of the patient's bronchial openings to thereby bias the end of said suction catheter which extends through said distal end of said tubular member toward the one of the patient's bronchial openings, and for rotating said open face of said beveled tip to face the other of said patient's bronchial openings to thereby bias the end of said suction catheter which extends through said distal end of said tubular opening toward the other of said bronchial openings without forming a kink or obstruction in said passageway by twisting the proximal end of said tubular member so that either of the patient's bronchial tubes can be selectively subjected to suction for removal of residual secretions therefrom.   
     
     
       14. The combination of claim 13 wherein said tubular member includes a thickened wall portion adjacent to said cuff inflation lumen.